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« Health Affairs Study - Only Canada Ranks lower than US in Adoption of EMR by Primary Care Physicians | Main | Purchase of an EMR - Single Practice vs. Collective Approach »

Comments

Michelle Greiver

Google is useful for tools as well. I recently saw a patient in my office with possible post-partum depression, and wanted to use the Edinburgh post natal scale. I entered those terms in Google and found several sites with the scale; I printed one and used it.

Michelle

Karim Keshavjee

Google may not be as good as the article above states. An excellent article in the Nov/Dec issue of JAMIA by McKibbon and Fridsma shows that many resources that family physicians use actually lead them to incorrect answers. You can find the reference at JAMIA Article

Family Physicians need better training in how to use information resources appropriately.

Karim

Karim Keshavjee

For those who are interested in the latest on clinical decision support tools for use in primary care, check out Compete
III Study

This is a presentation I recently made at the American Medical Informatics Association meeting on the COMPETE III study. The presentation provides an overview of the COMPETE III study and some initial information about patient and physician response.

We are in the process of analyzing the results of the randomized controlled trial involving over 1100 patients. We have also recently completed a willingness to pay study, which we hope to present at e-health in May 2006.

Alan Brookstone

An article in the BC Medical Journal by the librarians from the BC College Library Services provides constructive insight into the use of Google as a decision support tool.

"A question commonly posed to the College librarians is “I use Google. It that okay?” Google’s simple search page and retrieval of what is often “good enough” information makes for an appealing gateway to medical literature. But is it good enough to support clinical decision making? Google (www.google.ca) potentially searches any material on the web but, without editorial control, critical evaluation of results is essential. Google Scholar (scholar.google.com) limits its search to scholarly material but does not make clear the breadth of that subset. Google indexes documents word for word, which can be very useful when searching for obscure subjects or topics discussed briefly in the text of a document. However, filtering the search results for high-quality material such as systematic reviews and randomized controlled trials can be haphazard and time-consuming. Search results are sorted by proprietary algorithms, notably page rank, which assigns importance based on the number and quality of other Internet sites that link to the document. This ranking process has contributed greatly to Google’s success—relevant material tends to appear in the first few hits. However, the same ranking process causes new material to appear deep in the result list. Google does not search web-based databases like PubMed in real time so MEDLINE citations may not be the most recent.

PubMed, one of several interfaces that search MEDLINE, is a good example of a resource that can consistently retrieve valid and relevant information with a minimum amount of effort. The article information that PubMed searches is part of a clearly defined database of peer-reviewed journal content that is indexed for access by subject headings as well as text words. Mastery of the medical subject heading (MeSH) vocabulary is not essential as PubMed maps the search statement to subject headings “behind the scenes,” often resulting in reasonably precise and sensitive results. Search results are displayed chronologically so the most recent research is displayed first. A “clinical queries” tool filters results to identify systematic reviews and other high-quality material. The link to PubMed on the College Library’s web site is specially constructed to ensure that College members link to the Library’s full-text electronic journals in their PubMed search results. So use Google, but do so critically and not exclusively. Start your searches in resources that lead to evidence-based information created from critical appraisals of systematic searches of the literature, such as Cochrane Database of Systematic Reviews, PIER (ACP’s Physician Information and Education Resource), and MEDLINE, using PubMed, Ovid or other search interfaces. Include Google to capture documents other than journal articles or to discover that gem floating out there on the web that escaped your initial search of high-quality resources.

Link: BCMJ - google

Linda Clendenning,Karen MacDonell, Judy Neill, Librarians/Co-Managers

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